<?php  
    $attributes = array('class' => 'form-horizontal');
    echo form_open("thanhvien/thanhvien_diachi/update_diachi/".$query['id']);
   
?>
<div class="modal fade bs-example-modal-lg" tabindex="-1" role="dialog" aria-labelledby="mySmallModalLabel" aria-hidden="true">
    <div class="modal-dialog modal-sm">
        <div class="modal-content" style="width: 500px; margin-left: -110px;">
            
            <div class="panel panel-info">
                <div class="panel-heading">
                    <h3 class="panel-title">Thông tin địa chỉ</h3>
                </div>
            </div>
            <div class="panel-body">   
                    
            <div class="form-group row">
                 <div class="col-xs-4">
                    <label class="control-label" for="tinhthanh">Tỉnh, thành:</label>
                 </div>
                 <div class="col-xs-8">
                    <input type="text" id="tinhthanh" name="tinhthanh"  Class="form-control" placeholder="tỉnh, thành phố..."  value="<?php echo $diachi['tinhthanh']; ?>" />
                     <?php echo form_error('display_name'); ?>
                 </div>
            </div>
            <div class="form-group row">
                <div class="col-xs-4">
                    <label class="control-label" for="quanhuyen">Quận, huyện:</label>
                </div>
            <div class="col-xs-8">
        <input type="text" id="quanhuyen" name="quanhuyen"  Class="form-control" placeholder="quận, huyện..."
               value="<?php echo $diachi['quanhuyen']; ?>" />
               <?php echo form_error('quanhuyen', '<p class="text-danger" style="font-size:15px;">', '</p>'); ?>
    </div>
</div>
<div class="form-group row">
    <div class="col-xs-4">
        <label class="control-label" for="xaphuong">Xã, phường:</label>
    </div>
    <div class="col-xs-8">
        <input type="text" id="xaphuong" name="xaphuong"  Class="form-control" placeholder="xã, phường..."
               value="<?php echo $diachi['xaphuong']; ?>" />
               <?php echo form_error('xaphuong', '<p class="text-danger" style="font-size:15px;">', '</p>'); ?>
    </div>
</div>
<div class="form-group row">
    <div class="col-xs-4">
        <label class="control-label" for="diachi">Địa chỉ:</label>
    </div>
    <div class="col-xs-8">
        <input type="text" id="xaphuong" name="nhaduong"  Class="form-control" placeholder="địa chỉ nhà..."
               value="<?php echo $diachi['diachi']; ?>" />
        
               <?php echo form_error('daichi', '<p class="text-danger" style="font-size:15px;">', '</p>'); ?>
        <h5 class="text-muted">Ví dụ: 356 Lý Thường Kiệt</h5>
    </div>
</div>

                    <!--button-->
                    <div class="form-group">
                        <div class="col-xs-3"></div>
                        <div class="col-xs-3">
                            <button type="submit" class="btn btn-primary btn-sm btn-block">Thay đổi</button>
                        </div>
                                            
                            <div class="col-xs-3">
                                <button type="button" class="btn btn-default" data-dismiss="modal">Huỷ</button>
                            </div>
                        
                    </div>  <!--end button-->
                
             </div>    
            
            </div>
    </div>
</div>
<?php echo form_close(); ?>